Addiction Flashcards
(123 cards)
1
Q
Definition of addiction
A
- A state in which a person engages in compulsive behaviour despite its harmful consequences
- The behaviour is reinforcing and a person may suffer a lack of control in limiting their intake
- Can suffer physical and mental withdrawal symptoms
2
Q
What is physical dependence?
A
- A result of long term use
- A physiological need for a drug, marked by unpleasant withdrawal symptoms when discontinued
e. g. Delirium tremors with alcohol cessation - Normal day to day functioning becomes reliant of the drug
- Accompanied by tolerance i.e. requiring increased doses in order to obtain the same effect
3
Q
What is psychological dependence?
A
- When a person must continue to take the drug in order to satisfy intense, mental and emotion cravings
- Feels that they cannot cope with work and social life without the drug
- Absence of the drug causes feelings on anxiousness, irritability or depression and cravings for the substance
- The addiction is in the mind and a central focus
4
Q
What is tolerance?
A
The diminishing effect with regular use of the same dose of drug, requiring the user to take larger and larger doses before experiencing the same effect - Body adjusts to chronic use 3 types - Metabolic tolerance - Neuroadaption - Learned tolerance
5
Q
What is metabolic tolerance?
A
Where the enzymes responsive for breaking down the drug become more effective, reducing the effect of the drug
6
Q
What is neuroadaption?
A
Where changes at the synapse occur e.g. down regulation may make receptors less sensitive or fewer in number - reducing the effect
7
Q
What is learned tolerance?
A
The result of practice, as the person has learned to function normally whilst under the influence of the drug and dealing with its effect
8
Q
What are the criteria for diagnosing CHRONIC problems of substance dependence? (7)
A
1) Tolerance
2) Withdrawal symptoms
3) Increasing doses
4) Unsuccessful attempts to cut down intake
5) Considerable time spent obtaining, using or recovering from the use of the substance
6) Important social, occupational or recreational activities are given up
7) Continuation of the use despite recognition that this causes physical or psychological problems
9
Q
How long/how many of the criteria must be shown for a diagnosis of CHRONIC substance dependence?
A
An individual must show 3 of the 7 criteria in a 12 month period to receive a diagnosis of chronic substance dependence
10
Q
What are the criteria for diagnosing ACUTE or EPISODIC problems of substance dependence? (4)
A
1) Interference with obligations in their major role e.g. at work, home or school
2) Recurrent use in potentially hazardous situations
3) Legal problems related to drug use
4) Continued use despite social or interpersonal problems caused by substance use
11
Q
How long/how many of the criteria must be shown for a diagnosis of ACUTE or EPISODIC substance abuse?
A
An individual must show 1 of the 4 of the criteria in a 12 month period to receive a diagnosis of acute or episodic substance abuse
12
Q
What are the five factors that make us more or less vulnerable to addictive behaviour?
A
1) Personality
2) Stress
3) Peer groups
4) Genetic influence
5) Family influence
13
Q
What are the four personality traits that can explain addictive behaviours? Who’s theory is this?
A
Eysenck’s (1967) Theory
1) Extroversion
2) Neuroticism
3) Psychoticism
4) Novelty seeking, harm avoidance and rewards dependence (Cloniger)
14
Q
How can extroversion explain addictive behaviours? (Personality)
A
Extroverts are chronically under aroused and so may take part in addictive behaviours to gain stimulation in the CNS
15
Q
How can neuroticism explain addictive behaviours? (Personality)
A
Neurotic people experience negative affect e.g. Anxiety and so may engage on addictive behaviours to alleviate tension through a form of self medication
16
Q
How can psychoticism explain addictive behaviours? (Personality)
A
This relates to sensation seeking, impulsivity and being emotionally detached. Eysenck also related this to dopamine function. It is believed that psychotic people are most susceptible to addictions as they help manage these personality traits
17
Q
How can Novelty seeking, harm avoidance and rewards dependence explain addictive behaviours? (personality)
A
It makes them more vulnerable to substance abuse
18
Q
Strengths of personality as an explanation of addictive behaviours. (4)
- evidence to support
- evidence to support
- reliable study
- evidence to support
A
1) Supporting evidence for personality and impulsivity from Belin - Put rats in device where they could self administer cocaine, one group were sensation seekers and the other was impulsive - sensation immediately took large dose but impulsive rats became addicted
2) Evidence from Coa and Su - sample of 2620 high school kids from 4 schools aged 12-18 - completed surveys on personality and internet usage - 64 (2.4%) diagnosed with internet addiction also higher scores of neuroticism and psychoticism
3) High number of addicts have personality disorders - Verhheul (1995) - Found personality disorders approx 44% in alcoholic, 70% in cocaine addicts and 79% for opiate addicts - makes factor more convincing
4) Reliable study (Cao and Su) used standardised procedures to replicable if need be
19
Q
Weaknesses of personality as an explanation of addictive behaviours. (3)
- issues with cause and effect
- studies lack generalisability
- methodological issues
A
1) Cause and effect issue - Teeson said research was correlational, although personality traits are common they cannot predict behaviours - also unknown which came first - implies personality is inconclusive
2) Belins study uses rats and suggests evolutionary discontinuity so lacks generalisability - rats and humans have qualitative differences e.g. language system - Belins research cannot support as we cannot generalise
3) Methodological issues - Generalisability only done in China so is ethnocentric and done on students ages 12-18 so cannot be generalised to other ages
20
Q
How does stress cause addictive behaviours according to the ‘tension-reduction hypotheses’?
A
Cappell and Greeley’s tension reduction hypothesis says people may engage in addictive behaviours to reduce tension and anxiety. Tension creates a heightened sense arousal and addictive behaviours will reduce this.
21
Q
How does everyday stress cause addictive behaviours?
A
- Addiction is related with relieving anxiety
- People report that they drink, smoke, gamble use drugs etc. as a way to cope with daily hassels such as relationships, money issues, work stress etc.
- Stressors may contribute to initiation and continuation of addictions
- Can also contribute to relapse after long periods of abstinence
22
Q
How does traumatic stress cause addictive behaviours?
A
- Research has found that people exposed to severe stressors are vulnerable to addictions, especially in children to have experience parental loss or abuse
- PTSD is linked to addiction - Drissen found 30% of drug addicts and 15% on alcoholics have PTSD
- Exposure to ‘mere trauma’ was not sufficient to lead to addiction
23
Q
Strengths of stress as an explanation for addictive behaviours. (2)
- evidence to support
- evidence to support
A
1) Evidence to support that stress is related to substance abuse - Schneier found alcohol dependence occurs twice as much in those with social phobias - shows a clear relation
2) Evidence that stress is linked to addiction in uni students - Tavolacci’s research examined risk factors that may precode addiction at uni - compared highly stressed student with students with less stress and found high stress was related to smoking regularly, alcohol abuse and risk of internet addiction -suggests they are linked
24
Q
Weaknesses of stress as an explanation for addictive behaviours. (3)
- other explanations to consider
- no cause and effect
- redcutionist
A
1) Individual differences need to be considered e.g. personality traits like hardiness or resilience - some people can deflect everyday stresses and don’t let them affect them, but others have little tolerance and turn to addictions to cope - it’s an incomplete explantion
2) There is a cause and effect issue with stress - there is evidence that links stress and addiction but it is largely retrospective with no before measurements so we cannot assume it causes addiction
3) The theory is reductionist
25
From what age do peer networks replace parents as the primary source of reinforcement?
12-14 years (Hinde 1985)
26
How does NSI explain experimentation in addictive behaviours?
- NSI is driven by our emotions, we have a fear of being rejected by a group
- Many adolescents begin experimenting in addictive behaviours that are found in other members of their friend group
27
What two theories can be used to explain peer networks influence in addiction?
1) Social Learning Theory (SLT)
| 2) Social Identity Theory (SIT)
28
How does research into social learning theory explain peer networks influence in addiction?
- Research states that you learn through observation through others that you have the most contact with
- Peer encouragement and approval can serve as big reinforcements\
- But once an addictive behaviour is started direct experience determines whether they continue it
29
How does the Social Identity Theory explain peer networks influence in addiction?
- States that much of our social identity is gained through members of in-groups - we adopt norms and behaviours of the group
- e.g. if smoking is a central component of the group then the individual is more likely to smoke
30
What parts of addiction do Peer networks influence most?
- Most research shows how they influence the initiation and maintenance of addictions
- But they are also important in relapse as they can increase access to drugs and even encourage relapse
31
Strengths of peer groups as an explanation for addictive behaviours. (2)
- evidence to support
- practical applications
1) Evidence to supports - Sussman and Ames found peer use of drugs was the best predictor of future drug use, peers help to create 'normative perceptions' that behaviours are socially acceptable - shows peer influence is a significant factor
2) Research has good practical applications - Social Norm Interventions have been developed to address adolescent behaviours and attitude formation - focuses on adolescent perceptions of how peers think and corrects misconceptions - decreasing addictions and substance dependence
32
Weaknesses of peer groups as an explanation for addictive behaviours. (3)
- difficult to make general laws
- reductionist
- only correlational
1) Role of peer networks is influenced by age - as people get older they often have more knowledge to reject peer pressure which makes it harder to establish normative laws - psychologists thus cannot make general laws for everyone as addictive behaviours are influenced by age.
2) Reductionist claim - peers are unlikely to be the only factor shaping addictive behaviours - personality traits such as extroversion also impact addictive behaviours - extroverts are 'chronically under aroused' and so may be more likely to be influenced in addictive behaviours
3) The factor is only correlational - it's unclear whether group memberships or addictive behaviours appear first, or whether they are both a result of a 3rd factor such as personality - this means we cannot establish a cause and effect relationship between peer groups and addictive behaviours
33
What gene has been suggested to be present in addicts?
A1 DRD2 gene (commings et al)
34
How have genetic influences been implicated in addictive behaviours?
- They create a genetic vulnerability is developing some addictive behaviours
- Can explain why some become addictive after just sampling the addictive behaviour
35
How does the gene A1 DRD2 influence addictive behaviours?
- It reduces the dopamine receptors in our pleasure centres in the limbic system
- Means individuals with this gene are less sensitive to rewards and may seek out extra stimulating activities to compensate
36
What is the 'reward deficiency syndrome', who suggested it and how does it cause addictive behaviours?
- Suggested by Blum et al (1996)
- Individuals seek out extra stimulating activities because they are less sensitive to rewards due to a lack of dopamine receptors
- It creates genetic vulnerabilities in many compulsive disorders
- 60% of a sample of alcohol dependant users and 51% of cocaine dependent users had the variant gene A1 DRD2
37
What did Vink et al find out about nicotine addictions?
Found that being addicted to nicotine was influence primarily - 75% - by genetic factors
38
Strengths of genetic risk factors as an explanation of addictive behaviours. (2)
- evidence to support
- diathesis stress account
1) Evidence to show that genetics are involved - Shields examined concordance between 42 twin pairs reared apart and found only 9 pairs were dis-concordat (smoking) - showing genetic similarity is a major factor
2) Genetic factors can be used as part of the diathesis stress account - some people may have a biological predisposition when carrying the A1 DRD2 gene and when exposed to stressful situations this may trigger addictive behaviours to show
39
Weaknesses of genetic risk factors as an explanation of addictive behaviours. (2)
- explained by nurture as well
- overly deterministic
1) Findings can easily be explained using nurture and environmental influences - SLT explains this as if you see a role model engaging in addictive behaviours e.g. gambling then you may be inclined to copy the behaviour if it shows some positive effects e.g. earning money (vicarious reinforcement) - meaning the role of genetics is not the only explanations
2) The role of genetics in addiction is overly deterministic- it implies we have no free will and that if we possess any faulty genetic traits then we will be addict - The A1 DRD2 variant is not present in all cases of addiction and is common in 'the normal population' (20%) as well as OCD and Tourettes sufferers - means genetic factors are not exclusive
40
What 3 theories can explain family influences as an explanation for addictive behaviours?
1) Social learning theory
2) Shaping our expectations/schema
3) Parenting styles
41
How does Social Learning theory suggest we learn addictive behaviours through family influences?
- It suggests we model our behaviours on key role models, often found in the home e.g. parents and siblings
- SLT suggests we may learn to become addicted to behaviours through vicarious reinforcement and role models
42
How does family shaping our expectancies of the world influence addictive behaviours?
- Families shape expectancy of the world and this contribute to our schemas
- If we are led to believe that addictions such as alcohol and smoking relieve stress and boredom then we may initiate this behaviour ourselves, expecting rewards
43
How does parenting styles influence addictive behaviours?
- The degree of parental control and warmth that is shown to the growing child affects addictive behaviours
- Authoritative parenting (showing warmth but also appropriate control) have been associated with shaping psychological resilience and emotional well being - with low levels of substance abuse
44
Strengths of family influences as an explanation of addictive behaviours. (2)
- evidence to support
- practical applications
1) Evidence for role of SLT - Goddard's longitudinal research examine factors that may predict smoking behaviour - main finding that if parents smoke the kids are more likely to + Murray found if parents were anti smoking then kids were 7 times less likely to smoke - implies parents lead by example
2) Practical applications - if families are seen as influencing child's tendencies towards addictive behaviours then intervention strategies can focus on this factors and target parents with the aim to emphasis the extent of their influence and persuade them to model positive behaviours - can help reduce addictive behaviours
45
Weaknesses of family influences as an explanation of addictive behaviours. (2)
- explained by other factors
- less important than peer influence
1) Research has a theoretical flaw as it can also be explained by genetics - shield's research showed that out of 42 twin pairs, reared apart, only 9 were dis-concordat - suggesting that genetic similarity is a major factor and that family influences may be overstated
2) Role of peer influence is argued to be more critical in teenage years than parental influence - Sussman and Aimes research shows that peer use of drugs was on of the best predictors of future drug use and believed that peers help to create normative perceptions to make those behaviours acceptable - suggests parental influence is more critical in early years.
46
How do genes and dopamine function effect smoking initiation?
Some people inherit a genetic vulnerability to start smoking by the candidate gene A1 DRD2, which codes for defective and insufficient dopamine receptors in the brains reward circuity.
So these individual may engage in smoking to raise dopamine levels in order to produce pleasure
47
Why are we likely to repeat smoking behaviour/using nicotine?
Nicotine is a stimulant and increases the production and activity of dopamine in the mesolimbic pathway. This acts as very rewarding and thus are likely to repeat the behaviour
48
What are the 5 stages showing the role of dopamine in smoking maintenance?
1) Nicotine stimulates specific acetylcholine receptors (NAcR) which increases alertness, memory function and learning
2) This causes a rise in dopamine activity in the ventral tegmental area (VTA) - which is seen to underline rewarding sensations linked to smoking
3) The VTA activity cause by nicotine is then projected to the nucleus accumbens (NA)
4) The nucleus accumbens is the primary reward centre in the brain, when activity is increased here, dopamine rises, which causes users to evaluate smoking as very pleasurable which compels further use
5) The nucleus accumbens is encourage to release more dopamine, nicotine stimulates endorphin that reduces GABA in the NA - decrease in GABA correlates to a rise in dopamine as GABA usually suppresses dopamine - this increase forces smokers to smoke again
49
What is NAcR?
Nicotine acetylcholine receptors
50
What is the VTA?
Ventral Tegmental Area - a critical area in the brains reward circuit this is highly populated with NAcR
51
How does down-regulation and up-regulation affect nicotine use - The Nicotine Regulation Model (1977)
- Nicotine causes dopamine to fire in the mesolimbic pathway which acts as a reward for the smoker
- With LT use the NRM says that the smokers reward system becomes less active (down regulates) as specific acetylcholine receptors become inactive, creating anxiety, lethargy and sadness
- In order to avoid these effects smokers continue smoking to maintain a certain level of nicotine and avoid side effects (negative reinforcement)
- As a result of down regulation in the mesolimbic pathway, an increasing amount of nicotine is needed to achieve the same effect as the receptors have been ground down
52
Strengths of brain chemistry and dopamine in explaining nicotine addiction. (3)
- evidence to support
- practical applications
- scientific
1) Evidence support from Paterson's (2002) research - found support for the role of nicotine and dopamine through research of epilepsy drug Gamma Vinyl GABA - reduces surge of dopamine the the nucleus accumbens that occur after nicotine, reducing addictive properties of nicotine without side effects
2) Biochemical explanation has led to practical applications - The Nicotine Regulation Model (NRT) - delivers therapeutic doses of nicotine in early stages of stopping smoking - the use of inhalers has been shows to keep 28% of the treatment group off for 12 months - can help population
3) Praised for scientific methodology - the account uses empirical and falsifiable methods to identify biochemical action of nicotine e.g. NT levels can be measured through cerobro-spinal fluids , PET scans and examining urine - trustworthy
53
Weaknesses of brain chemistry and dopamine in explaining nicotine addiction. (4)
- reductionist
- only suggests nature (nature v nurture)
- overly deterministic
- beta bias
1) Approach is reductionist and does not consider other factors that may influence addiction such as personality factors like being an extrovert, which may also cause an individual to seek arousal through smoking
2) The approach only offers an account of the nature side of addiction and ignores the role of nurture - peer influence can affect addiction as suggested by the SLT, suggesting that external factors also play a role - explanation could be more comprehensive
3) The account is overly deterministic - implies we have no free will and if we posses the faulty genetic traits then we will be addicted - no the case as suggested by Blum and Commings et al, possessing the A1 DRD2 gene only increases in nicotine addiction by 40%
4) Explanation accused of a beta bias - neglects to address and explain differences between male and female addictions - Nerin and Jane argue that the onset of smoking is different between the sexes - women start smoking later - explanation suffers a gender bias
54
How is nicotine addiction initiated as suggested by SLT? + evidence
ATTENTION - individuals when they are young watch their friends/family and see them smoking and being addicted to nicotine, and the habits that follow
RETENTION - they retain the information on HOW to smoke and what the effects of it are e.g. relaxation
REPRODUCTION - because they have watched their friends/family smoking they are also able to reproduce the action as they know how to
MOTIVATION - individuals, especially when young reproduce the actions as they are motivated to fit in with friends, and base their attitudes off of their role models
EVIDENCE = Survey by NIDA (2000) 90% of US smokers claim to have taken smoking as a teenager, and attributed this to watching friends/family do so
55
How is nicotine addiction maintained through immediate reinforcement? (consequential learning + peer acceptance)
Skinner says that immediate reinforces (rise in dopamine, stress relief, calm, improved concentration) take precedence over the long term consequences (lung cancer, earlier death, increased likelihood of strokes) as the consequences seem far away
25% of inhaled nicotine reaches the brain in 10 seconds validates this
56
How is nicotine addiction maintained through peer acceptance?
- Robinson (1997) said that peer acceptance and social identity influence smoking behaviour
- Milton et ls qualitative study found young smokers identify peer influence as an important factor in smoking and the rejection from peer groups as key
- Thus peer acceptance acts as a reinforcer to help maintain smoking behaviour
57
How is nicotine addiction maintained/relapsed into by negative reinforcement?
- As the effects of nicotine begin to wear off, with repeated exposure, users can experience unpleasant symptoms e.g. nausea, insomnia, cravings
- Taking more nicotine stops these negative experiences, the removal of negative states and addition of more pleasure may increase the frequency of smoking and addiction
- Learning to maintain the behaviour through avoidance learning
58
How is nicotine addiction maintained/relapsed into by cue reactivity (Carter and Tiffany 1999)
- Classical conditioning says smoking is maintained and relapsed due to triggers/cues in the environment that are associated with smoking
- Triggers = conditioned stimulus, which elicit a conditioned response even in the absence of smoking behaviour
- Ex smokers can relapse if they return to the same environment and friend groups
59
Strengths of using the learning approach as an explanation of smoking addiction. (3)
- practical applications
- evidence to support
- scientific
1) Cue reactivity theory has led to useful practical application to treat those with smoking addiction - Addictive behaviours are aroused int he presence of various stimuli e.g. alcohol - cue exposure therapy presents certain cues to the sufferer and helps them to control their reactions by coping strategies, fading away the response of smoking in the presence of cues
2) Experimental support to show the role of vicarious reinforcement in smoking by Harakeh (2007) - used data from 428 families with two children between 13-17 collected through surveys, found no smoking adolescents with older siblings who smoked or a friend who smoked were likely to start smoking a year later - illustrates the role of reinforcement
3) Focuses on observable behaviour creating a falsifiable/scientific account - focuses on physical effects e.g. cue and removal of cues, and the influence of peers and family behaviours - implies the explanation is credible/trustworthy
60
Weaknesses of using the learning approach as an explanation of smoking addiction. (2)
- doesn't consider individual differences
- environmentally deterministic
1) Neglects to consider individual differences - Robinson and Berridge argue that many people try nicotine but do not become addicted despite rewarding effects on offer, suggesting other factors must also be at work that allow some to become addicted but not all - implies other factors must be considered
2) Takes an environmental deterministic approach - suggests if your environment and role models are addicted to smoking it is inevitable that you will face the same fate, does not consider the role of personal autonomy - creates a theoretical problem for the explanation.
61
How can the learning approach explain Gambling initiation?
Children imitate legitimate gambling behaviours that are shown by role models
Role models are seen to be gambling, winning and enjoying the 'thrill' e.g. Saturday night lottery so the behaviour is seen as acceptable, attractive and rewarding and so may begin to gamble
62
How can the cue reactivity theory explain gambling maintenance?
Triggers/cues in the environment have been associated with gambling and so maintain the behaviour
Triggers = Conditioned Stimulus e.g. music, lights, alcohol
which elicit a conditioned response even in the absence of gambling (classical conditioning)
63
What is a fixed interval reinforcement schedule?
The first response after a given interval of time is reinforced e.g. rewards may be given after every 5 mins
64
What is a fixed ration reinforcement schedule?
Every Nth response may be reinforced e.g. on a fruit machine every 25th play may be reinforced
65
What is a variable interval reinforcement schedule?
On average the first response after a given interval of time is reinforced, but this time interval varies e.g. could be 5 mins one day or 25 mins the next
66
What is a variable ratio reinforcement schedule?
Every Nth response is reinforced but the actual gap between reinforcement varies, it can be large e.g. a fruit machine pays out 25% of the time, however these wins may occur in a small space of time, followed by long winless plays - most powerful schedule
67
What does partial reinforcement mean?
It means gambling behaviour is only rewarded on some occasions and not on all occasions
68
Why are variable ration reinforcement schedules the most effective?
They're the most effective in maintaining the behaviour once gambling is initiated
The gambler does not win every time the play, and so become obsessed with continued play and 'chasing the win', hence the behaviour becomes maladaptive
69
What are the strengths of the learning explanation of gambling? (2)
- evidence to support
- practical applications
1) It has experimental support that it it is related to positive reinforcement - Grant et al (2004) found in a sample of gamblers who relapsed, 40% did so because they missed the 'thrill' or the 'buzz' of gambling - implying the positive reinforcement is too much to resist and that the learning account is credible
2) Has led to practical applications - cue exposure therapy involved resenting the cue to the individual e.g. bright lights of a casino and then helping them to control their reactions to it by developing coping strategies - the response of gambling in the presence of cue fades away - means the explanation has benefited society
70
What are the weaknesses of the learning explanation of gambling? (3)
- reductionist
- contradictory evidence
- evidence for other factors
1) The approach is reductionist - it assumes if you witness gambling from a young age that it is inevitable that you will have an addiction, it doesn't take into account the other factors, like genetics could influence this, like inheriting the A1 DRD2 gene
2) There is contradictory evidence that highlights the limitations - Robinson & Berridge (1993) point out that many people try gambling yet do not become addicted despite all the rewarding experiences, this suggests that other factors must be at work causing this addiction
3) Evidence that gambling has it's roots in our genes, which may contribute more than the environment - Blum and Cummings identified gamblers are more likely to possess the A1 DRD2 genetic variant predisposition to gambling + Shah et al found in twin studies that there was strong genetic transmission in men for gambling
71
What does the cognitive explanation suggest about gambling?
It emphasises the irrational thought processes - and suggests that in essence, gamblers are 'faulty information processors'
It means that addicts are making a series of misattributions about their addiction, encouraging it further
72
How does the cognitive explanation suggests that gambling is initiated through a 'self medication bias'
It suggests that addictive gambling has started to alleviate negative cognitive states in an individual, and that it creates a 'buzz' of excitement that initially raises mood levels
73
How is gambling maintained according to the cognitive explanation?
Through cognitive biases such as:
- Cognitive myopia
- The gamblers fallacy
- Illusions of control
- The 'near miss' bias
- The recall bias
74
What is cognitive myopia? (gambling)
A cognitive bias - Gamblers focus of the immediate gratifying state far more than long term consequences of heavy gambling e.g. financial, social and family problems
This is a biased way of processing information and suggests decision making is at fault
75
What is the gamblers fallacy?
The mistaken notion that the odds for something with a fixed probability increase or decrease depending on recent occurrences e.g. a coin toss 3 heads in a row will be balanced out by the opposite outcome
76
What are illusions of control? (gambling)
This is demonstrated through the performance of superstitious behaviours, which the gambler believes their behaviour helps to manipulate the event outcome
Pathological gamblers often have exaggerated self confidence in being able to 'beat the system' due to the different attributions that gamblers make e.g. success being down to personal skill
77
What is the 'near miss' bias? (gambling)
Near misses are when an unsuccessful outcome is close to a win e.g. when a horse betted on comes second in the race or 2/3 cherries are on a slot machine
The gambler feels that they are constantly nearly winning rather than losing
Near misses also have rewarding value for gamblers despite lacking monetary reinforcement that often comes with gambling
78
What is the recall bias? (gambling)
The tendency to remember and overstate wins, whilst forgetting about or understating losses - they then also believe that they will be rewarded for their efforts and are motivated to return to gambling on subsequent occasions
79
What are the strengths of the cognitive account of gambling addiction? (2)
- supporting evidence
- practical applications
1) Evidence to support - Griffiths (1994) compared 30 regular gamblers and 30 non-regular gamblers given £3 to spend on fruit machines, while there verbalisation was observed - regular gambler believed they were skilled and made more verbal statements - non regular gamblers believed their playing was mostly chance
2) Led to practical applications - CBT can correct the cognitive biases which would also reduce the motivation to gamble - Ladoucer et al (2001) found CBT to be 66% effective when treating 66 pathological gamblers - has potential to help the 1/2 a million gambling addicts in the UK
80
What are the weaknesses of the cognitive account of gambling addiction? (3)
- reductionist
- no cause and effect
- evidence for other factors
1) Account is reductionist - gambling can also be explained by possessing the A1 DRD2 giving them a predisposition to low dopamine levels
2) Sufferers from a lack of a cause and effect relationship - unsure is gambling is a result of cognitive biases or if cognitive biases are a result of gambling, and gambling is actually caused by a third factors - suggests account could be more comprehensive
3) Evidence that it has its root in genes - Blum and Cummings identified that Gamblers are more likely to possess the A1 DRD2 gene, giving them a biological predisposition to gambling
81
Definition of drug therapy.
Drug treatments involve the use of chemical therapies designed to have a particular effect on the functioning of the brain or body systems
82
What are 3 types of drug therapy used to treat smoking addiction?
1) Agonist substitution - Nicotine replacement therapy
2) Antagonist - Bupropion
3) Partial agonist - Varenicline
83
What are agonist drugs and how do they work?
- They initiate a physiological response by binding to neuron receptor sites and activating them
- Agonist drugs act as a replacement for the drug and produce a similar effect
e. g. methadone to treat heroine and NRT to treat smoking addiction
84
What are antagonist drugs and how do they work?
- They inhibit a physiological response by binding to neuron receptor sites and blocking them
- They act as an obstruction for the drug and prevent it from causing its usual effects
e. g. Bupropion to treat smoking
85
How does Nicotine Replacement Therapy (NRT) work?
By delivering therapeutic doses of nicotine in the early stages of stopping smoking - the release of nicotine is absorbed more slowly and steadily than in tobacco.
It still causes action on NAcR and Dopamine.
86
What is the most effect type of nicotine replacement therapy?
E-Cigarettes as they also resemble the activity of smoking like handling and inhaling
87
What is the mode of action for nicotine replacement therapy?
1) It works by releasing a clean (no tar) controlled dose of nicotine into the blood stream
2) The nicotine binds to acetycholine receptors in the mesolimbic pathway, stimulating the release of dopamine
3) Using NRT means that the amount of nicotine can be gradually reduced, reducing the severity of withdrawal symptoms
88
What is the mode of action for bupropion?
1) Bupropion is an antagonist at nicotine receptors and may work by blocking nicotine effects so there is no rise in dopamine levels when you smoke
2) Bupropion is also a weak inhibitor of dopamine and noradrenaline re-uptake - leading to an overall increase in dopamine while taking the drug which may relieve withdrawal symptoms and thus the chance of relapse
3) The treatment lasts 7-12 weeks with 1 week of treatment before the smoker attempts to stop smoking
89
How does partial agonist therapy work?
By delivering doses of Varenicline which partially stimulates the release of dopamine whilst reducing the effectiveness of nicotine, so that if the individual continues to smoke on the drug it will have less of a desirable effect
90
What is the mode of action for Varenicline?
1) Varenicline is a highly water soluble salt, similar to the structure of nicotine
2) It binds to nicotine acetycholine receptors in the mesolimbic pathway stimulation the release of moderate levels of dopamine
3) Varenicline produces 32-60% of the dopamine response to nicotine and acts as a partial antagonist blocking the effects of nicotine and inhibit the effects of repeated nicotine exposure
91
What are the strengths of drug therapies in treating smoking addiction? (2)
- Evidence to support
- Evidence to support
1) Evidence to support long term effectiveness of NRT - Stead et al (2012) reviewed 150 studies into the effectiveness of NRT and found it to be more effective than placebo's or no treatment - users 70% more likely to be abstaining from smoking 6 months after quitting - implies it is helpful
2) Evidence to support effectiveness of Bupropion - Hughes et al (2014) carried out a meta analysis of 44 trials of bupropion and found that those taking the drug had significantly higher chance of quitting successfully after 6 months - implies its effectiveness
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What are the weaknesses of drug therapies in treating smoking addiction? (3)
- Ignore underlying reasons
- Doesn't help to quit
- Removes responsibilities
1) Drug therapies ignore the underlying reasons for why people smoke - overlooks causal factors like the influence of peer groups - if smoking is a central component to the peer groups then therapies do not target this social pressure and its effects - means once therapy stops many will relapse
2) May not help smokers to really quit - It may be a case of replacing one addiction for another - nicotine is still release into the body and still has the effects of an increased heart rate and raised blood pressure - so may not actually be helping addicts quite
3) Drug therapies may remove the responsibility from the individual as they see smoking as a disease that can be treated.cured without conscious effort - NRT still relies on will power and may be more effective when combined with other treatments like CBT
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What are the two behavioural interventions used in treating smoking addiction?
Aversion therapy and covert sensitisation
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How does aversion therapy work?
It works on the principles of association and tries to replace positive associations to addictions with aversive/negative associations - originally designed for alcohol addictions but has been applied to many
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How has aversion therapy been applied to alcohol addiction?
Antabuse (emetic drug and UCS) = Vomiting (UCR)
Alcohol (former CS) = Pleasure (formed CR)
Antabuse + Alcohol = Vomiting
Alcohol = Vomiting
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How has aversion therapy been applied to smoking in the form of 'rapid smoking'?
- The client must break any positive association with smoking
- They are required to sit in a closed room and take puffs of a cigarette every 6 seconds (much faster than normal)
- Rapid inhalation and exposure to fumes leads to feelings of nausea
- Underlying this is the newly formed negative feelings the smoker will associate with nicotine (and develop an aversion to it)
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What are the strengths of aversion therapy in treating smoking addiction? (1)
- Evidence to support
Evidence to support the effectiveness - Howard's study assessed effects of aversion therapy in 82 US alcoholics across 5 sessions in a 10 day trial - each session given an emetic drug and there preffered alcoholic drink - vomiting occurred 5-8 mins after taking the drink - repeated many times with different drinks so positive alcohol related expediencies decreased and the belief that they could refrain from drinking increased
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What are the weaknesses of aversion therapy in treating smoking addiction? (3)
- ethical issues
- doesn't address real cause
- not effective long term
1) Ethical issues - violates rights to withdraw as the study requires you to carry on even during the most unpleasant experiences + not protected from physical or psychological harm - may not be an ideal treatment for vulnerable addicts
2) Doesn't eliminate the actual problem, only the behaviour - it only associates the addictive behaviour with a negative experience, but does not stop the urges or what causes them
3) Not effective long term - when exposed to an environment associated with the dug after therapy, mental and physical changes may be reactivated and may relapse (cue reactivity)
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What is covert sensitisation?
A variation of aversion therapy - draws on same principles of CC, involves imagined negative associations between previous CS and new UCS to produce a new CR
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How is covert sensitisation different to aversion therapy?
Covert sensitisation uses in vitro methods rather than in vivo methods
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What are the strengths of covert sensitisation to treat addiction? (2)
- evidence to support
- deals with some ethical issues
1) Evidence to support - McConaghy et al compared aversion therapy with covert sensitisation for gambling, both were effective in removing urges to gamble, but in a 1 year follow up 90% of those using CS had reduced gambling, compared to 30% of those with AV
2) Deals with ethical issues - protected from physical and psychological harm as they are not actually experiencing any negative effects + can withdraw if they wish to easily and have more control over the treatment
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What are the weaknesses of covert sensitisation to treat addiction? (1)
- does not solve underlying issues
Only addresses the behavioural aspects of addiction - the root cause and the thoughts that trigger is are still there, but there are just different associations and reactions to them, and they may even turn to other substances that don't have negative associations - only a partial treatment
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What does the cognitive explanation emphasise about addiction?
It emphasises irrational thought processes and suggests that addicts are making a series of misattributions about their addiction
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What is cognitive restructuring? (CBT)
It's where therapists work with an individual to address some of the cognitive biases that feed their addiction
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What is involved in functional analysis? (CBT)
- The therapist works with the client for up to 5 sessions where they focus on identifying behavioural patterns and thought about the addiction
- The client is encourage to come up with reasons for attempting to change their addictive behaviours - focusing on problems faced due to dependency and the benefits of abstinence
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What are interpersonal factors?
"Between people" - could include social pressures such as peer groups or the environment
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What are intrapersonal factors?
"Within" - could include stress or negative emotions
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What is relapse prevention?
Relapse prevention focuses on helping the individual to develop techniques to learn how to cope with temptations - could include positive self statements or distraction techniques
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What are the strengths of using CBT as a treatment for addiction? (3)
- evidence to support
- cost effective
- all round effectiveness
1) Evidence to support - Ladoucer et al (2001) randomly allocated 66 pathological gamblers to CBT or a waiting list, CBT involved relapse prevention and cognitive correction - of those that completed CBT 86% were no longer classified as gambling addicts by the DSM , they had better perception of control and increased self efficiency and results remained at 1 year follow up
2) Short term nature makes it an attractive option - Miller et al (2003) claimed it had the best chance of treatments and is cost effective, it is quick acting and promotes coping skills, in a meta analysis of 381 studied CBT was the best treatment for alcoholism
3) All round effectiveness - CBT not only works with many different addictions, it is also successful with other mental health conditions, meaning that it is generalisable
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What are the weaknesses of using CBT as a treatment for addictions? (2)
- methodological issues with evidence
- not a 'quick fix'
1) Methodological issues with Ladoucer's study - Validity, the two groups can't be compared as the group in therapy will always improve, also CBT does not really deal with the root cause - Reliability, lacked between therapists as they may treat different patients with different addictions differently
2) Some clients do not respond to CBT as it is a treatment that requires motivation and the want to get better themselves, it also requires them to recognise their free will in their addiction, in this case other treatments may be more attractive e.g. drug therapy, as it is a cure that acts as a 'quick fix'
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What are the three components to the Theory of Planned Behaviour (TPB)?
Behavioural attitude
Subjective norm
Perceived behavioural control
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What does 'behavioural attitude' refer to in TPB?
A positive or negative evaluation of the behaviour (gambling, drinking, smoking etc.) combined with a belief about the outcome or consequences of the behaviour
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What does 'subjective norms' refer to in TPB?
The perception of what other people think about the behaviour (gambling, smoking, drinking etc.)
Is it socially acceptable? Is everyone else doing it?
The social norms are influential if the individual wants to conform to the group
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What does 'perceived behavioural control' refer to in TPB?
How much a person believes that they can control their behaviour.
Influenced by assessment of INTERNAL factors - skills, drive, will power and EXTERNAL factors - education, support, past experiences
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What is 'intention' in TPB?
When a person makes a decision that they are going to do something e.g. stop smoking
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What does intention lead to in TPB?
A behaviour or act e.g. stop smoking
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How can TPB be applied to addictive behaviours? (positive)
People who have a positive attitude to giving up and who want to conform to social norms of a group that is anti addiction, and who believe that they can control their behaviour and have the resources to give it up - will have the intention to give up and will give up their addiction
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How can TPB be applied to addictive behaviours? (negative)
People who had a negative attitude to giving up, who think it will be too unpleasant, whose reference group are still addicts and who want to continue to belong to this group and conform to their social norms believing they will be unable to control their urges - will not have the intention of giving up and will not give up their addiction
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How can Theory or Planned Behaviour be used to change behavioural intentions?
Campaigns e.g. to lower teen drug use, try to include a focus on changing the attitudes of the target audience towards the drug identified e.g. showing how taking drugs is incompatible with the individuals - aim is to make people re-think their behaviour
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How can Theory of Planned Behaviour be used to change subjective norms?
Anti drugs/smoking campaigns often try to correct misconceptions of levels of drug taking in teens e.g. adolescents who smoke may believe that 'all teenagers smoke' but this is not the case - those trying to reduce addiction can try to correct these subjective norms and give accurate info
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How can Theory of Planned Behaviour be used to change perceive behavioural norms?
Research by Godin et al (1992) found that the most important prediction of smoking behaviour was the perceived behavioural control - suggests strategies to help prevent smoking addiction should focus on developing will power and informing on the effort required
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How can Theory of Planned Behaviour be used to increase self efficacy?
Self efficacy is an important factor in predicting the ability to change behaviour and give up an addiction - therefore increasing an individual's self efficacy by encouraging their belief in their ability to abstain from addictive behaviours should be apart of treatments
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What is a strength of Theory of Planned Behaviour?
| - supporting evidence
White et al (2008) assessed sun protection intentions and behaviours in young people in Australia - 1000 pt's aged 12-20 completed a questionnaire assessing TPB predictors and two weeks later the recorded their sun protection behaviours for the past fortnight - showed TPB predictors were significant in predicting intention and behaviours
